Randomised trial of two schedules of chemotherapy of the same dose/time intensity in untreated small cell lung cancer (SCLC) of poor prognosis

INTERVENTION: 1. Standard Regimen: Multi‐drug chemotherapy, cyclophosphamide, adriamycin and vincristine alternating every 21 days with etoposide and cisplatin. A total of six courses, three with each drug combination. 2. Low Dose/High Frequency Regimen: Multi‐drug chemotherapy, etoposide and cisplatin alternating every 10/11 days with cyclophosphamide, adriamycin and vincristine. A total of twelve courses, six with each drug combination. This schedule uses the same drugs as in the standard regimen but at half the dose and twice the frequency with the same intended overall dose intensity. CONDITION: Lung (small cell) ; Cancer ; Lung (small cell) PRIMARY OUTCOME: Not provided at time of registration SECONDARY OUTCOME: Not provided at time of registration INCLUSION CRITERIA: 1. Histologically or cytologically proven small cell carcinoma of the lung 2. Aged 75 or under 3. Extensive disease and poor prognosis, ie Eastern Cooperative Oncology Group (ECOG) performance status 2 or 3 and/or alkaline phosphatase >1.5 upper limit of normal range 4. Adequate renal function 5. No previous malignancy, except non melanomatous skin cancer in the preceding 3 years 6. No previous chemotherapy or radiotherapy, except for emergency radiotherapy for superior vena cava obstruction 7. No medical contraindications to treatment